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Positive predictive value of the diagnosis of acute myocardial infarction in an administrative database
L A Petersen1, S Wright, S L Normand
1Center for the Study of Practice Patterns in Acute Myocardial Infarction, Health Services Research and Development, Roxbury VA Medical Center, Boston, Mass., USA.
Insights
The positive predictive value for coding acute myocardial infarction and cardiac procedures in administrative data is high. This study found coding accuracy comparable to or better than previous research.
Area of Science:
- Health Informatics
- Cardiovascular Medicine
- Medical Coding Accuracy
Background:
- Administrative databases are crucial for healthcare research.
- Accurate coding of diagnoses and procedures is essential for data integrity.
- Previous studies have shown variable accuracy in administrative coding.
Purpose of the Study:
- To evaluate the positive predictive value of ICD-9-CM codes for acute myocardial infarction.
- To assess the accuracy of coding for cardiac procedures like catheterization, bypass surgery, and angioplasty.
Main Methods:
- Utilized chart-abstracted data as the gold standard for comparison.
- Analyzed administrative data from a national random sample of 5,151 discharges from the Veterans Health Administration.
- Calculated positive predictive value, sensitivity, and specificity for specific codes.
Main Results:
- The positive predictive value for acute myocardial infarction coding was 96.9%.
- High sensitivity and specificity were observed for cardiac procedures: catheterization (96%, 99%), coronary artery bypass graft surgery (95.7%, 100%), and percutaneous transluminal coronary angioplasty (90.3%, 99.7%).
Conclusions:
- ICD-9-CM coding for acute myocardial infarction demonstrates high positive predictive value.
- The accuracy of coding for related cardiac procedures is robust, supporting the reliability of administrative data for research.
Objective:
To determine the positive predictive value of ICD-9-CM coding of acute myocardial infarction and cardiac procedures.
Methods:
Using chart-abstracted data as the standard, we examined administrative data from the Veterans Health Administration for a national random sample of 5,151 discharges.
Main Results:
The positive predictive value of acute myocardial infarction coding in the primary position was 96.9%. The sensitivity and specificity of coding were, respectively, 96% and 99% for catheterization, 95.7% and 100% for coronary artery bypass graft surgery, and 90.3% and 99. 7% for percutaneous transluminal coronary angioplasty.
Conclusions:
The positive predictive value of acute myocardial infarction and related procedure coding is comparable to or better than previously reported observations of administrative databases.
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